Abstract

BACKGROUND:
Neonatal septicemia is a clinical syndrome characterize by signs and symptoms of infection in                  the first month of life associated with high Morbidity and mortality rates if not treated properly. Platelet indices (biomarkers of platelet activation which include mean platelet volume, platelet distribution width, mean platelet mass, platelet large cell ratio, and immature platelet fraction) are of diagnostic value in a variety of settings including the sepsis some are  studied very rarely.                            In automatic complete blood picture platelet count, mean platelet volume and platelet distribution width are a group of platelet indices determined together related to morphology and proliferation kinetics of the platelets.
OBJECTIVE:
To determine the role of platelet indices (platelet counts, MPV and PDW) in  the diagnosis of neonatal sepsis , to detect the value of these indices in determining  the type of bacteria causing the sepsis and to study the association of the platelet indices (platelet count, MPV & PDW) with gestational age, birth weight and onset of sepsis.
PATIENTS AND METHODS:
A prospective, case–control study, conducted at Neonatal care unit in Children Welfare Teaching hospital, from the first of June 2019 to the end of June 2020, included 90 neonates with signs and symptoms of sepsis and positive blood culture considered as patients group with other 90 healthy neonates as control group from outpatient clinic. Blood samples were drawn from each neonate of sepsis and control groups for white blood cell, hemoglobin, absolute neutrophil count, platelet count, MPV and PDW and blood culture were sent for patients groups.
RESULTS:
55 (61.1%) patients were males and 35(38.9%) patients were females, 24 (26.7%) patients below age of 7 days, 39(43.3%) patients were preterm (GA<37wk), 45(50%) neonates of the sepsis group were low birth weight (less than 2.5kg). In control group,70(77.8%) neonates below the age of 7 days, 41(45.6%) neonates were low birth weight, there were matching between control and sepsis groups regarding gestational age and gender. Platelet indices including MPV and PDW (except platelet count) were increased with statistical significance in sepsis group in comparison to control group (P<0.05) regardless of gestational age and birth weight. All these indices were statistical significant  in early onset sepsis but not in late onset sepsis. There were no statistical significant for platelet indices (platelet count, MPV and PDW) between subgroups of sepsis neonates regarding gram stain, onset of             sepsis, gestational age and birth weight (P>0.05).
CONCLUSION:
Neonatal sepsis has significantly increased platelet indices (MPV and PDW) compared to healthy neonates regardless of Gestational age and birth weight. Thrombocytopenia and an increase in MPV with PDW are seen significantly in neonates with EOS (Early onset sepsis) but not significant in late onset sepsis compared to control. Platelet indices are not significantly different (decrease in platelet count and increase in MPV with PDW) between Gram-positive and Gram-negative   bacteria, so     the platelet indices are not specific findings in determining different types of sepsis bacteria.